考六气之中，湿气在乎秋令。故经谓“秋伤于湿”。湿土之气，内应乎脾，脾土受湿，不司运化，内
湿酿成痰饮，上袭于肺，遂为咳嗽病矣。夫六气之邪，皆能令人咳嗽，又不独乎湿也。斯言湿者，是为伏气
咳嗽，有西昌喻嘉言先生疑湿字之讹，改作秋伤于燥，发明秋燥之论，虽有悖经之罪，然亦因乎六
气起见也。盖《内经》论湿，殆在乎立秋、处暑、白露湿土主气之时；喻氏论燥，殆在乎秋分、寒露、霜
降燥金主气之候。据愚意更有界限分焉∶窃谓秋初伤湿不即发者，湿气内酿成痰，痰袭于肺而作嗽，名曰痰
嗽，治宜理脾为主，渗湿为佐。如秋末伤燥，不即发者，燥气内侵乎肺，肺失清降而作咳，名曰干咳，
治宜理肺为主，润燥为佐。总之不越两太阴之治也。斯言伤湿伤燥而咳嗽者，皆由秋令之伏气
而发于冬。其即发者，仍归伤湿秋燥门中治之。
痰嗽者，因痰而致嗽也。夫作嗽之病，风、寒、暑、热，皆能致之。古人议论纷纭，惟李云间、章
若耶二先生，皆括为内伤、外感。观其立论，卓荦不群，然与《内经》“秋伤于湿”之嗽无
预。丰不揣鄙陋而特补之。斯病也，良由立秋以后，秋分以前，先伤于湿，湿气内踞于脾，酿久成痰，痰袭
于肺，气分壅塞，治节无权，直待冬来，稍感寒气，初客皮毛，渐入于肺，肺气上
逆，则潜伏之湿痰，随气而逆，遂成痰嗽之病矣。其脉必见弦滑，或见微紧，右寸关必较余部不调，舌苔
白润，胸次不舒，痰白而稀，口不作渴，此皆秋湿伏气之见证也。理当治脾为主，渗湿化痰为佐，宜以加味
二陈法治之。如有恶寒发热者，再加苏梗、前胡；气喘者，加之旋复、苏子，当随其证而损益之。
或问∶作嗽之病，四时皆有。今观是篇，独发于冬，他时之嗽，因何勿论耶？答曰，子不观本论中，
原有风、寒、暑、热皆能致之之说，四时都有咳嗽之病也。曰∶何不分而论之。曰∶前之风温、风热、风寒、
冒风、暑咳、秋燥，以及后之冬温条中，皆有咳嗽之证。若重复而论之，能不令人心厌乎？是论专
言伏气酿痰致嗽，而风、寒、暑、热致嗽者，可毋重赘耳。
考察六气之中，湿气对应于秋季的时令。所以经典中说“秋伤于湿”。湿土之气，在内与脾脏相应，脾土受到湿气侵袭，不能正常运化水液，导致体内湿气酝酿成痰饮，向上侵犯肺部，于是形成了咳嗽病。六气的邪气，都能让人咳嗽，并不仅仅是湿气所致。这里专门谈论湿气，是针对伏气温咳（指邪气潜伏体内，过时而发的咳嗽）。西昌的喻嘉言先生怀疑“湿”字是讹误，将其改为“秋伤于燥”，并阐发了秋燥的理论。虽然这有违背经典的罪过，但也是基于六气变化的考虑。大概《内经》论述湿气，大致是在立秋、处暑、白露这些由湿土主气的时节；而喻氏论述燥气，大致是在秋分、寒露、霜降这些由燥金主气的时段。依我愚见，二者更有界限区分：我认为初秋受湿如果不立即发作，湿气在体内酝酿成痰，痰侵犯肺部引发咳嗽，名叫痰嗽，治疗应以调理脾胃为主，渗利湿气为辅。如果是秋末受燥，如果不立即发作，燥气内侵肺部，肺失去清肃下降的功能引发咳嗽，名叫干咳，治疗应以调理肺脏为主，润燥为辅。总之，不离太阴经（手太阴肺经、足太阴脾经）的治疗原则。这里所说的因伤湿或伤燥导致的咳嗽，都是由秋季的伏气在冬季发作。那些立即发作的，仍然归入伤湿或秋燥的门类中治疗。
痰嗽，是因为有痰而导致的咳嗽。引起咳嗽的病证，风、寒、暑、热邪气，都能导致。古人的议论纷纭复杂，只有李云间、章若耶两位先生，都将它们概括为内伤和外感两类。看他们的立论，卓越出众，然而这与《内经》中“秋伤于湿”引起的咳嗽没有关联。我不揣冒昧，特意对此进行补充。这种病，确实是由于立秋之后、秋分之前，先被湿气所伤，湿气内居于脾脏，日久酿成痰，痰侵犯肺部，气分壅塞，肺的治节功能无权，一直等到冬天来临，稍微感受寒气，寒气最初客居皮毛，逐渐深入肺部，肺气上逆，那么潜伏的湿痰，随着气机而上逆，于是形成了痰嗽病。其脉象必定呈现弦滑，或者微紧，右寸关脉一定比其他部位不调和，舌苔白润，胸中不畅快，痰白色且稀薄，口不觉得渴，这些都是秋湿伏气的见证表现。理应当以治疗脾脏为主，渗湿化痰为辅，适宜用加味二陈汤来治疗。如果有恶寒发热的症状，再加苏梗、前胡；如果气喘，加上旋覆花、苏子，应当根据具体证候增减药味。
有人问：引起咳嗽的病证，四季都有。现在看这篇论述，唯独强调在冬季发作，其他季节的咳嗽，为什么不讨论呢？回答说：你没看本论中，原本就有风、寒、暑、热都能导致咳嗽的说法，四季都有咳嗽的病证啊。问：为什么不分别论述呢？答：前面的风温、风热、风寒、冒风、暑咳、秋燥，以及后面的冬温条文中，都已经有了咳嗽的证候。如果重复论述，难道不会让人心生厌烦吗？这篇论述专门讲伏气酿痰导致咳嗽，而由风、寒、暑、热导致咳嗽的，就可以不再赘述了。
In the examination of the Six Qi (Six Excesses), dampness corresponds to the seasonal timing of autumn. Thus, the classics state "injury by dampness in autumn." The qi of damp earth internally corresponds to the Spleen. When Spleen Earth is affected by dampness, it fails to govern transportation and transformation, leading to internal dampness brewing into phlegm-fluids (Tan-Yin). These ascend to invade the Lungs, thereby forming a cough disease. The pathogenic factors of the Six Qi can all cause coughing; it is not limited solely to dampness. This discussion on dampness specifically addresses latent-qi cough (cough caused by pathogens lying dormant within the body until triggered later). Mr. Yu Jiayan from Xichang suspected that the character "dampness" was an error and changed it to "injury by dryness in autumn," expounding upon the theory of autumn dryness. Although this bears the fault of contradicting the classics, it arose from considerations regarding the changes of the Six Qi. Generally speaking, the *Neijing* discusses dampness, likely referring to the times when damp-earth governs the qi, such as Start of Autumn (Liqiu), End of Heat (Chushu), and White Dew (Bailu); whereas Mr. Yu's discussion on dryness likely refers to the periods when dry-metal governs the qi, such as Autumn Equinox (Qiufen), Cold Dew (Hanlu), and Frost Descent (Shuangjiang). In my humble opinion, there are even clearer boundaries: I propose that if one is injured by dampness in early autumn and does not manifest immediately, the dampness brews into phlegm internally, which invades the Lungs causing cough, named Phlegm-Cough (Tan Sou). Treatment should primarily regulate the Spleen, with promoting diuresis to drain dampness as an adjunct. If one is injured by dryness in late autumn and does not manifest immediately, the dryness internally invades the Lungs, causing the Lungs to lose their clear descending function and resulting in cough, named Dry Cough (Gan Ke). Treatment should primarily regulate the Lungs, with moistening dryness as an adjunct. In summary, these do not exceed the treatment principles of the Two Taiyin (Hand-Taiyin Lung Meridian and Foot-Taiyin Spleen Meridian). The coughs mentioned here, caused by injury to dampness or dryness, all arise from latent qi of autumn manifesting in winter. Those that manifest immediately still belong to the categories of injury by dampness or autumn dryness for treatment.
Phlegm-cough is coughing induced by phlegm. Diseases causing cough can be brought about by Wind, Cold, Summerheat, and Heat. Ancient scholars' discussions were numerous and varied; only Mr. Li Yunjian and Mr. Zhang Ruoye summarized them into Internal Injury (Nei Shang) and External Contraction (Wai Gan). Observing their theoretical framework, it was outstanding and unique, yet it had no relevance to the cough described in the *Neijing* as "injury by dampness in autumn." Presuming my own ignorance, I specially supplement this. This illness is indeed caused by being first injured by dampness after Start of Autumn but before Autumn Equinox. Dampness resides internally in the Spleen, brewing over time into phlegm. The phlegm invades the Lungs, causing stagnation in the Qi level, rendering the governance and regulation (Zhi Jie) powerless. One must wait until winter arrives, when slight cold is contracted. Initially, the cold lodges in the skin and hair, gradually entering the Lungs. Lung Qi rebels upward, causing the latent damp-phlegm to rebel along with the Qi, thus forming the disease of Phlegm-Cough. The pulse will necessarily appear wiry and slippery, or slightly tight. The Right Cun and Guan positions will be more discordant than other parts. The tongue coating will be white and moist, the chest feel uncomfortable, the phlegm white and thin, and there is no thirst. These are all manifestations of latent autumn-dampness qi. Treatment should primarily focus on the Spleen, with draining dampness and resolving phlegm as an adjunct. It is appropriate to treat with Modified Er Chen Decoction (Jia Wei Er Chen Tang). If there are aversion to cold and fever, add Perilla Stem (Sugeng) and Peucedani Radix (Qianhu); if there is panting, add Inula Flower (Xuanfu) and Pericarpium Sojae Preparatum (Suzi). Dosages should be increased or decreased according to the specific syndrome.
One might ask: Cough diseases occur in all four seasons. Now, looking at this chapter, it focuses exclusively on onset in winter. Why are coughs in other seasons not discussed? The answer is: Have you not seen the statement in this treatise that Wind, Cold, Summerheat, and Heat can all cause cough? Cough diseases exist in all four seasons. One asks: Why not discuss them separately? The reply is: In the preceding sections on Wind-Warmth, Wind-Heat, Wind-Cold, Wind-Encounter, Summerheat-Cough, and Autumn-Dryness, as well as in the subsequent section on Winter-Warmth, cough syndromes have already been addressed. To repeat them would surely cause boredom. This discussion specifically addresses cough caused by latent qi brewing phlegm; those caused by Wind, Cold, Summerheat, and Heat need not be repeated.